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Full-Text Articles in Medicine and Health Sciences
Progres Recents Dans Le Traitment Des Intoxications Au Paracetamol, Alison Jones, P Lheureux
Progres Recents Dans Le Traitment Des Intoxications Au Paracetamol, Alison Jones, P Lheureux
Alison L Jones
Au Royaume-Uill et aux EtatsUills, Ie parac~tamol est utilise depuis plus de 40 ans comme antalgique de premiere ligne en raison de sa securite d'emploi a dose tMrapeutique. Au RoyaumeUni, il figure parmi les substances les plus sou vent impliquees dans les tentatives de suicide, seul dans la majorite des cas ou en association avec l' alcoo!. En moyenne, six patients intoxiques par cet antalgique sont admis chaque jour a la Poisons Unit de la Royal Infirmary d'Ectimbourg (incidence annuelle 400/100 000 habitants). Parmi eux, 0,02 % vont developper une Mpatite fulminante. Le parac~tamol en est la cause la plus …
Paracetamol Poisoning: Can It Be Prevented? , E Norman, R Dhairiwan, Paul I. Dargan, Craig I. Wallace, Alison L. Jones
Paracetamol Poisoning: Can It Be Prevented? , E Norman, R Dhairiwan, Paul I. Dargan, Craig I. Wallace, Alison L. Jones
Alison L Jones
No abstract provided.
Paracetamol (Acetaminophen) Overdose, Alison Jones
Paracetamol (Acetaminophen) Overdose, Alison Jones
Alison L Jones
A 23-year-old woman. who is 34 weeks pregnant with her first child, is seen In the Emergency Department after taking 28 paratetamol (500 mg) tablets 2 h ago. She is 62 kg in weight. She did not co-ingest any other drug or alcohol. She complains of nausea and intermittent vomiting. but this has been consistent throughout her pregnancy.
A Young Woman Who Has Taken An Overdose Of Paracetamol (Acetaminophen), Alison Jones
A Young Woman Who Has Taken An Overdose Of Paracetamol (Acetaminophen), Alison Jones
Alison L Jones
No abstract provided.
Drug Interactions With Paracetamol, M Toes, Alison Jones, L Prescott
Drug Interactions With Paracetamol, M Toes, Alison Jones, L Prescott
Alison L Jones
Paracetamol (acetaminophen) is one of the most commonly used analgesic antipyretic drugs worldwide, and it is widely available by prescription and over the counter (OTC). Fortunately, few clinically significant drug interactions have been documented. There is probable potentiation of hepatotoxicity following an overdose from the paracetamol metabolite NAPQI by enzyme-inducing drugs. There is considerable controversy regarding the possible interaction with warfarin in its potential to increase its anticoagulant effects because of discrepancies between observational studies and those in healthy volunteers. Otherwise, no serious adverse drug interactions with therapeutic doses of paracetamol have been confirmed in humans. Because the absorption of …
Should Methionine Be Added To Every Paracetamol Tablet?, Alison Jones, P Hayes, A Proudfoot, J Vale, L Prescott
Should Methionine Be Added To Every Paracetamol Tablet?, Alison Jones, P Hayes, A Proudfoot, J Vale, L Prescott
Alison L Jones
Paracetamol is commonly used for self poisoning, and the costs of treating the resulting liver failure in the few who develop it are high. The morbidity could be avoided by adding methionine to paracetamol tablets, but this would mean that the millions of people who take paracetamol responsibly would have to take methionine unnecessarily. Alison Jones and colleagues and Edward Krenzelok debate the issue.
Paracetamol: Balancing Risk Against Benefit, Paul Dargan, Alison Jones
Paracetamol: Balancing Risk Against Benefit, Paul Dargan, Alison Jones
Alison L Jones
No abstract provided.
Comparison Of Assays For Measuring Plasma Paracetamol. Possibility Of Calibration Error Needs Evaluation, Alison L. Jones, D R. Jarvie, D Simpson, L F. Prescott
Comparison Of Assays For Measuring Plasma Paracetamol. Possibility Of Calibration Error Needs Evaluation, Alison L. Jones, D R. Jarvie, D Simpson, L F. Prescott
Alison L Jones
Egleston et al report a significant difference in plasma paracetamol concen trations assayed with the AcetaSite bench assay and a standard laboratory assay. Rapid and accurate determinations of plasma paracetamol concentrations are crucial in the expeditious and appropriate administration of antidotal treatment, which prevents severe liver damage if given sufficiently early in the course of poisoning.
Reduced Packet Sizes May Decrease Paracetamol And Salicylate Self-Poisoning, Paul Dargan, Alison Jones
Reduced Packet Sizes May Decrease Paracetamol And Salicylate Self-Poisoning, Paul Dargan, Alison Jones
Alison L Jones
BACKGROUND Paracetamol is commonly used in cases of deliberate self-poisoning. Overdoses are a major cause of liver failure in the United Kingdom. Legislation introduced in September 1998 aimed to reduce such incidents by restricting the size of over-the-counter paracetamol packaging and including specific health warnings. OBJECTIVE To evaluate the effect of legislative changes restricting ‘over the counter’ paracetamol and salicylate package sizes on self-poisoning rates. SETTING Five liver units and seven general hospitals, United Kingdom; September 1996-September 1999. METHOD Before and after observational study.
Paracetamol Overdose: An Evidence Based Flowchart To Guide Management, Craig Wallace, Paul Dargan, Alison Jones
Paracetamol Overdose: An Evidence Based Flowchart To Guide Management, Craig Wallace, Paul Dargan, Alison Jones
Alison L Jones
A flowchart for the management of patients with paracetamol poisoning is presented to help clinicians in the emergency department. Paracetamol is the commonest drug taken in overdose in the United Kingdom. While the management of early paracetamol poisoning is straightforward, the management of late presenting cases, cases presenting after a staggered overdose, and patients with risk factors for paracetamol poisoning can be much more complex. The authors have developed and present here an evidence based flowchart that will guide clinicians step by step through the investigation and treatment of all patients presenting to hospital after this common, but often difficult …
Recent Advances In The Management Of Late Paracetamol Poisoning, Alison Jones
Recent Advances In The Management Of Late Paracetamol Poisoning, Alison Jones
Alison L Jones
Management of early paracetamol poisoning is dependent on prompt administration of N-acetylcysteine to patients whose plasma concentrations of paracetamol exceed the normal-risk or high-risk treatment lines. Paracetamol poisoning presenting after 15 h since ingestion, especially as fulminant hepatic failure, requires meticulous supportive care of organ dysfunction. The putative mechanisms of action of N-acetylcysteine and its practical use are discussed. The best prognostic marker for paracetamol poisoning in 'established hepatotoxicity' is the prothrombin time. Indications for liver transplantation in paracetamol poisoning and exclusion criteria are also discussed.
Paracetamol Availability And Recent Changes In Paracetamol Poisoning: Is The 1998 Legislation Limiting Availability Of Paracetamol Being Followed?, S Greene, Paul Dargan, P Leman, Alison Jones
Paracetamol Availability And Recent Changes In Paracetamol Poisoning: Is The 1998 Legislation Limiting Availability Of Paracetamol Being Followed?, S Greene, Paul Dargan, P Leman, Alison Jones
Alison L Jones
Objective: To determine the degree of adherence to legislation introduced in 1998 restricting the availability of over the counter paracetamol. Design: A prospective observational study. Setting: An emergency department in an inner city London teaching hospital. Pharmacy and nonpharmacy outlets in south London. Main outcome measures: (1) The source of paracetamol ingested by 107 patients presenting with an acute paracetamol overdose (2001–2003) and (2) the ability to purchase paracetamol from pharmacy and nonpharmacy outlets in a manner contravening paracetamol pack size legislation (2004). Results: Potentially toxic amounts of paracetamol in excess of pack size restrictions were purchased in 70% (17 …
Management Of Paracetamol Poisoning, Paul Dargan, Alison Jones
Management Of Paracetamol Poisoning, Paul Dargan, Alison Jones
Alison L Jones
Paracetamol is the most common substance involved in self-poisoning in the UK. The main advances made over the past five years in the management of early paracetamol poisoning, identification of risk factors for paracetamol poisoning, understanding of the mechanisms and management of late paracetamol poisoning and issues concerning the prevention of paracetamol poisoning are discussed.
Should A Lower Treatment Line Be Used When Treating Paracetamol Poisoning In Patients With Chronic Alcoholism? A Case Against, Paul Dargan, Alison Jones
Should A Lower Treatment Line Be Used When Treating Paracetamol Poisoning In Patients With Chronic Alcoholism? A Case Against, Paul Dargan, Alison Jones
Alison L Jones
The widespread practice of using a lower plasma paracetamol (acetaminophen) concentration threshold for the treatment of paracetamol poisoning in patients with chronic alcoholism has been introduced on the basis of anecdotal case reports. In animals, acute alcohol loading inhibits toxic metabolic activation of paracetamol whilst chronic alcohol administration results in cytochrome P450 (CYP) 2E1 induction with increased toxic metabolic activation of paracetamol by CYP2E1 and increased hepatotoxicity. However, due to species differences in CYP expression, activity and induction, it is not possible extrapolate the results of these animal studies to clinical situations in humans. Isoenzymes are also responsible for the …
Paracetamol (Acetaminophen) Poisoning: No Need To Change Current Guidelines To Accident Departments, P Routledge, J Allister Vale, D Nicholas Bateman, G. Denis Johnston, Alison L. Jones, Alan Judd, Simon Thomas, Glyn Volans, L F. Prescott, A T. Proudfoot
Paracetamol (Acetaminophen) Poisoning: No Need To Change Current Guidelines To Accident Departments, P Routledge, J Allister Vale, D Nicholas Bateman, G. Denis Johnston, Alison L. Jones, Alan Judd, Simon Thomas, Glyn Volans, L F. Prescott, A T. Proudfoot
Alison L Jones
Paracetamol is an effective, simple analgesic that is well tolerated by adults and children at therapeutic doses. In many countries it is available without prescription. Unfortunately, its ready availability is associated with episodes of poisoning that prompt 3.3% of inquiries to US regional poisons centres, 10% of inquiries to the UK National Poisons Information Service, and up to 43% of all admissions to hospital with self poisoning in the United Kingdom.3 In the United States paracetamol alone accounted for 4.1% of deaths from poisoning reported to American poisons centres in 1997. Most deaths are associated with deliberate self poisoning, but …
Unusual Complications Of Paracetamol Poisoning, Alison Jones, L Prescott
Unusual Complications Of Paracetamol Poisoning, Alison Jones, L Prescott
Alison L Jones
Every physician is only too familiar with acute hepatic necrosis as the most common complication of severe paracetamol poisoning. The frequency with which paracetamol is used for self-poisoning may, however, give rise to complacency through familiarity, and the less common complications may be missed. The purpose of this review is to act as a reminder of these more unusual complications. Although there have been many reports of toxic occurred in the presence of hepatic or multi-organ failure, and in such circumstances it is difficult to distinguish between cause and effect.